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Cardiovascular Medication Costs In Canada Double
The number of prescriptions in Canada for cardiovascular medications has been increasing over the past decade, with a 200% increase in costs, found a new study in CMAJ (Canadian Medical Association Journal). In 2006, total costs of cardiovascular medications exceeded $5 billion, with statins accounting for almost 40% of the expenditure.

1/4 Of Patients On Highest Investigational Doses Of CP-690,550 Achieve ACR70 At Week 12
A quarter of active rheumatoid arthritis (RA) patients receiving either 10mg (24.6%) or 15mg (28.1%) twice daily of the investigational oral JAK-3 (janus-associated kinase) inhibitor CP-690,550 (CP) achieved ACR70* after 12 weeks, according to the results of a new study presented at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark. The primary outcome for the study was ACR20*, with 75.4% of patients achieving this measure at 12 weeks for both 10mg and 15mg doses.
News of the day
GAO Report Finds Veterans Affairs Facilities Do Not Comply With Privacy Standards For Women
All Department of Veterans Affairs outpatient clinics and hospitals are failing to fully comply with federal privacy standards for women, according to a Government Accountability Office report, the AP/Boston Globe reports. The report comes as thousands of female veterans are entering the VA health system after returning from Iraq and Afghanistan.GAO auditors said that many VA facilities had gynecological tables that faced the door. In one instance, a gynecological table faced a door opening to a waiting room. The investigation also found cases where women had to walk through waiting rooms to use the restroom -- a violation of VA policy requiring adjoining restrooms. Four VA hospitals did not guarantee women access to private bathing facilities. In two of those cases, the facilities did not have locks.Nearly 20% of female veterans have been diagnosed with post-traumatic stress disorder, and many of them have experienced sexual trauma while serving, according to the report. The report also said that most female veterans at VA facilities are ages 20 to 29. On average, female veterans using VA facilities are much younger than male VA patients, it noted.Randall Williamson, director of health care issues at GAO, said that although top VA officials are committed to improving care for female veterans, facilities are not always taking simple steps, such as repositioning exam tables. Patricia Hayes, chief consultant for VA"s veterans strategic health care group, said that the agency recognizes issues and is making changes to address disparities in care. She noted that VA is creating a long-term plan for construction improvements to address space and building layout challenges (AP/Boston Globe, 7/15).
Endocrinology

Cognitive Benefits In Older Adults Who Have Regular Moderate Alcohol Intake

A glass of wine here, a nightcap there - new research out of Wake Forest University School of Medicine suggests that moderate alcohol intake offers long-term cognitive protection and reduces the risk of dementia in older adults. The study is being presented at the Alzheimer"s Association 2009 International Conference on Alzheimer"s Disease (ICAD), in Vienna on July 13. While previous studies have shown that moderate alcohol intake, particularly wine, is linked with lower risk of heart attacks and dementia, most of the studies have been done in middle-aged people, and it has remained unclear if the benefits of alcohol also apply to older adults in general or to older adults who might already have some mild memory problems. This is the largest, longest U.S. study to look at the effects of regular alcohol intake on dementia in seniors, both with and without memory problems. "As of yet, we still have no cure for Alzheimer"s disease and other dementias, so it is important to look for things that might help people prevent the disease," said Kaycee Sink, M.D., M.A.S (Masters of Advanced Studies in clinical research), a geriatrician and senior author of the paper. Moderate alcohol intake has been linked to lower risk of heart attacks, stroke, dementia, and death in middle-aged adults, but there is still controversy about alcohol intake in older adults." For the study, researchers began by examining and interviewing 3,069 individuals, 75 years or older and most without any memory or thinking problems, about their drinking habits. Participants were asked about beer, wine, and liquor. The investigators then categorized the individuals as abstainers (non-drinkers), light drinkers (one to seven drinks per week), moderate drinkers (eight to 14 drinks per week), or heavy drinkers (more than 14 drinks per week). All types of alcohol were included. The study subjects were then examined and interviewed every six months for six years to determine changes in their memory or thinking abilities and to monitor who developed dementia. Researchers found that individuals who had no cognitive impairment at the start of the study and drank eight to 14 alcoholic beverages per week, or one to two per day, experienced an average 37 percent reduction in risk of developing dementia compared to individuals who did not drink at all and were classified as abstainers. The type of alcohol consumed did not matter. For older adults who started the study with mild cognitive impairment, however, consumption of alcohol, at any amount, was associated with faster rates of cognitive decline. In addition, those who were classified in the heavy drinker category, consuming more than 14 drinks per week, were almost twice as likely to develop dementia during the study compared to non-drinkers with mild cognitive impairment. "We were excited to see that even in older adults, moderate alcohol intake decreases the risk of dementia," Sink said. "It is important to note, however, that our study found a significantly higher risk of dementia for heavy drinkers who started the study with mild cognitive impairment." The results are consistent with previous studies of middle-aged adults that suggest mild to moderate alcohol intake may reduce the risk of dementia, except in the case of individuals who already have mild to moderate cognitive impairment. The researchers" findings support current recommendations not to exceed one drink per day for women and two for men. It is unclear from this study whether an abstainer who begins drinking moderately in his/her 70s will experience the same benefit or if the benefit is associated with a long pattern of moderate alcohol intake that continues on into old age. "Our results suggest that older adults who are normal cognitively and drink moderately do not need to change their drinking behavior," Sink said. "If you have mild cognitive impairment however, it might benefit you to restrict your drinking and certainly not exceed one drink a day for women and two drinks a day for men. "The participants in this study self-reported their alcohol intake at the start, but it is unusual for people to start drinking in their 70s, so we assume that the habits they reported at the start of the study reflect stable drinking habits," Sink added. "Without scientific data showing that it is beneficial, I wouldn"t recommend that non-drinkers start drinking in their 70s. "We are starting to make progress in understanding how to prevent and treat Alzheimer"s and other dementias," she said. "It is a very exciting time to be involved in geriatrics research." Jessica Guenzel Wake Forest University Baptist Medical Center


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